Transdermal nicotine in smoking cessation. A meta-analysis.

A systematic search of the literature was made to identify relevant reports of clinical trials of transdermal nicotine, followed by detailed statistical analysis of the results to calculate a pooled estimate of the rate of smoking cessation. Both a fixed effect and a random effects model were used to calculate pooled estimates. The pooled odds ratio (OR) for short-term smoking cessation in favour of the transdermal patches was OR = 3.10. Using a random effects model, the risk difference (RD) in favour of the transdermal patches was RD = 0.25. The corresponding values for long-term cessation were OR = 2.26 and RD = 0.11. Skin irritation was a common adverse effect with incidence rates ranging up to about 70%. Nicotine transdermal patches were effective in promoting smoking cessation both in the short-term, with assessments at 3 to 10 weeks, and in the long-term, with assessment at 24 to 52 weeks. Long-term abstinence rates in subjects treated with nicotine patches for a few weeks remained higher than in subjects treated with placebo patches. Adverse effects were usually minor and transient, although subjects with a sensitive skin may find the applications intolerable. Further studies are required to confirm the value of nicotine patches in promoting smoking cessation in the absence of professional medical support and in general medical practices in the community.